title: Unified Balance Scale: an activity-based, bed to community, and aetiology-independent measure of balance calibrated with Rasch analysis.
abstract: OBJECTIVE
  To build a new activity-based, "bed to community", aetiology-independent measure of balance within the neurological rehabilitation setting by merging some existing scales.
  
  
  METHODS
  Balance scales were selected using a conceptual framework and subsequently administered to a convenience sample of adult patients with balance problems due to different neurological aetiologies. Data were then processed using classical psychometric analyses and Rasch analysis in order to construct a new balance measurement tool.
  
  
  RESULTS
  The Berg Balance Scale, the Tinetti Scales and the Fullerton Advanced Balance Scale were selected and administered to a sample of patients, giving 302 observations. Classical psychometric analyses (item and scale analysis; confirmatory factor analysis) were undertaken on the pooled 40-item set with confirmation of unidimensionality. The subsequent Rasch analysis allowed the identification of a 27-item set satisfying the Rasch Model's requirements for fundamental measurement, with further confirmation of unidimensionality by post-hoc confirmatory factor analysis.
  
  
  CONCLUSIONS
  The new scale (Unified Balance Scale) holds proven measurement properties and may be a candidate tool for "bed to community" balance measurement for patients with balance problems within the neuro-rehabilitation setting. Future studies are warranted to explore further its external validity and other clinical properties, as well as to improve its usability.
authors.affiliation: Rehabilitation Medicine Unit, AUSL Modena, Modena, Italy. fabiolaporta@mail.com
authors.forename: Fabio
authors.initials: F
authors.lastname: La Porta
authors.forename: Marco
authors.initials: M
authors.lastname: Franceschini
authors.forename: Serena
authors.initials: S
authors.lastname: Caselli
authors.forename: Paola
authors.initials: P
authors.lastname: Cavallini
authors.forename: Sonia
authors.initials: S
authors.lastname: Susassi
authors.forename: Alan
authors.initials: A
authors.lastname: Tennant
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009422:Nervous System Diseases / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D004856:Postural Balance / Q000502:physiology; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D020377:Self Efficacy